肘关节肌腱磁共振成像技术及临床应用  

Magnetic resonance imaging of the elbow joint tendon:imaging technique and clinical application

作　　者：白荣杰[1] 张恒[1] 钱占华[1] 詹惠荔 李亚雄[1] 王崧铭 Bai Rongjie;Zhang Heng;Qian Zhanhua;Zhan Huili;Li Yaxiong;Wang Songming(Department of Radiology,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院放射科,北京100035

出　　处：《中华医学杂志》2019年第45期3558-3562,3563,共6页National Medical Journal of China

基　　金：国家自然科学基金面上项目(81771809,81371515);北京市自然科学基金面上项目(7202063)。

摘　　要：目的研究肘关节肌腱的磁共振成像(MRI)技术及临床应用价值.方法经北京积水潭医院伦理审查委员会批准,选择2013年5月至2018年10月,38例(侧)肘关节损伤疼痛经手术证实的肌腱损伤患者的MRI资料,其中男23例(侧)、女15例(侧),年龄9-77岁,平均41岁.20名健康志愿者(40侧),其中男12名、女8名,年龄20-55岁,平均35岁.所有研究对象均行MRI检查,被检查者俯卧位,分别行T1加权像(T1WI)冠状位,质子压脂序列(PD-FS)冠状位、矢状位及轴位扫描.研究健康志愿者与损伤患者肘关节肌腱的MRI表现特点,并将肌腱损伤的MRI表现特点与手术结果进行对照分析,由双盲法分析确认.结果20名健康志愿者(40侧)肘关节肌腱在T1WI和PD-FS序列均表现为均匀的细条带状低信号.38例肘关节外伤患者,44条肌腱损伤(其中伸肌总腱损伤14例,屈肌总腱损伤10例,肱二头肌腱损伤3例,肱肌肌腱损伤患者7例,肱三头肌腱损伤患者10例).损伤的肌腱T1WI序列表现为纤维不连续,纤维增粗、模糊,PD-FS序列表现为肌腱走行区内信号不均匀增高,腱鞘积液,部分撕裂表现为纤维不连续、纤维增粗.完全撕裂表现为纤维中断、回缩,断端纤维结构消失被液体充填,其周围软组织水肿.结论肘关节肌腱MRI技术可清晰显示肌腱的精细解剖结构及损伤的影像学表现,对肌腱损伤的早期诊断与治疗方案的制定具有重要价值.Objective To explore the magnetic resonance imaging(MRI)imaging technique and the clinical application in ligament and tendons of elbow.Methods The study was reviewed and approved by an institutional review board of Beijing Jishuitan Hospital.A total of 20 normal volunteers with 40 elbows including 12 males and 8 females,aged from 20 to 55 years,with an average age of 35 years and 38 patients with 38 elbows who complained elbow pain with elbow injuries including 23 males and 15 females,ranged in age from 9 to 77 years,with an average age of 41 years old were chosen to undergo magnetic resonance examination between May 2013 and October 2018.All subjects underwent examination on coronal T1WI scan and PD-FS on three planes respectively in a prone position.Then the MRI characteristics of tendons in elbow of healthy volunteers and patients with elbow injuries were studied and the MRI features of tendon injury were compared with the surgical results and confirmed by double-blind method.Results Twenty normal volunteers without tendons or ligament injures showed homogeneous low-signal-intensity on T1-weighted and proton fat saturation sequence(PD-FS)images.In the 38 patients with elbow injuries,there were 44 tendon injuries,including 14 cases of common extensor tendon injuries,10 cases of common flexor tendon injuries,3 cases of biceps tendon injuries,7 cases of brachialis tendon injuries and 10 cases of triceps tendon injuries.The injuried tendons became thicker and discontinuity in T1WI and demonstrated heterogeneously increased signal intensity with effusion of tendon sheath in PD-FS.Partial tear showed discontinuity and thickening of tendons and the complete tear showed that the tendons were interrupted,retracted,the fiber structure disappeared and was filled with liquid,and the surrounding soft tissue edema was found.Conclusions MRI can demonstrate the anatomy and injuries features of tendons in elbow joint accurately.It is significance for the early diagnosis and treatment protocols of the tendons injuries.

关 键 词：肘关节 腱损伤 磁共振成像 解剖学 

分 类 号：R68[医药卫生—骨科学]